MEDICARE: MICA LAZARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1811496458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICA LAZARE

Provider Business Mailing Address
First Line	:	6807 LANTERN KEY DR
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33463-7465
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6807 LANTERN KEY DR
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33463-7465
Country	:	US
Telephone Number	:	561-536-8747
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2018
Last Update Date	:	02/09/2018

Similar Medicare Providers

1437584620 — LESHEKA MAYBERRY
Practice Location Address:

4412 COLUMBUS TRL
FORT WORTH, TX
76133-7465

Practice Phone: 469-685-3473
Practice Fax:

1508928482 — DR. BRIAN JOHN SEELY PSY.D.
Practice Location Address:

7465 SUNFISH LAKE CT NE
ROCKFORD, MI
49341-9074

Practice Phone: 616-874-2811
Practice Fax: 616-874-2811

1750443461 — NADINE CRACRAFT MS
Practice Location Address:

7465 W LAKE MEAD BLVD , SUITE 2-104
LAS VEGAS, NV
89128-1032

Practice Phone: 702-893-2390
Practice Fax:

1477769438 — DR. CHAD LEE CROSS PHD
Practice Location Address:

7465 W LAKE MEAD BLVD , STE 100
LAS VEGAS, NV
89128-1032

Practice Phone: 702-480-4891
Practice Fax: 702-562-1221

1245431899 — DR. JEANETTE RODRIGUEZ MFCC
Practice Location Address:

3532 NE 153RD ST APT 203
LAKE FOREST PARK, WA
98155-7465

Practice Phone: 206-310-7487
Practice Fax:

1174751713 — DR. JOHN H VIGIL D.C.
Practice Location Address:

7465 W LAKE MEAD BLVD , STE. 115
LAS VEGAS, NV
89128-1032

Practice Phone: 702-562-1244
Practice Fax: 702-562-1245

Directions to “ MICA LAZARE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.